Non-fasting triglyceride as an independent predictor of carotid restenosis after carotid endarterectomy or carotid artery stenting.

Abstract Objective Non-fasting serum triglyceride (TG) level is attracting more and more attention as an atherosclerosis-promoting factor. However, no study has investigated the relationships between non-fasting TG levels and carotid restenosis after carotid endarterectomy (CEA) or carotid artery stenting (CAS). The present study was conducted to investigate if non-fasting TG levels can be used to assess a risk for carotid restenosis after CEA or CAS. Methods This was a single-center retrospective study. The authors reviewed consecutive 201 primary carotid artery revascularization procedures (39 CEAs and 162 CASs), which were performed from 2008 to 2018 for 179 patients (163 males and 16 females) with atherosclerotic carotid stenosis, and were followed up for at least one year. Clinical variables including non-fasting lipid profiles and findings of magnetic resonance plaque imaging were compared between groups with and without post-procedural carotid restenosis (≥ 50% stenosis on ultrasonography). Results During a mean follow-up period of 1,413 days, 24 of 201 carotid stenosis (11.9%) suffered restenosis after successful revascularization procedures. Multivariate analyses demonstrated that non-fasting TG level was the only independent risk factor of post-procedural restenosis. The receiver-operating characteristic curve analyses revealed that a cut-off value of non-fasting TG to discriminate post-procedural carotid restenosis was 127.5 mg/dL that was much lower than the upper limit of normal. Conclusions This study first showed that non-fasting TG level may be a useful marker to predict carotid restenosis after CEA or CAS, and could be a new therapeutic target to prevent carotid restenosis after revascularization procedures.